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General NPI Number Information
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NPI Number | 1861982266
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Entity Type | Organization
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Legal Business Name | DRAGONFLY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 05/11/2018
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Last Update Date | 05/11/2018
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Provider Practice Location Address
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Address Line | 70 BENCHMARK RD SUITE 202
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City | AVON
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State | CO
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Zip | 81620
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Country | US
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Telephone | 970-306-7820
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 14
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City | RED CLIFF
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State | CO
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Zip | 81649-0014
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Country | US
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Telephone | 913-915-7581
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Fax |
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Authorized Official
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Title or Position | OWNER, CHIROPRACTOR
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Name | DR. VICTORIA ROBERT
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Credential | DC
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Telephone | 913-915-7581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHR.0007832
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License Number State | CO
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